Suture tipping apparatus and method

ABSTRACT

A process for tipping surgical sutures includes dispensing tipping agent one drop at a time and contacting the suture portion to be tipped with the drop of tipping agent. A transversely oriented lifting/wiping string may be used to lift the suture into contact with the drop and may wipe away excess tipping agent. Alternatively, a transversely oriented string may be used to catch a drop and then place the drop onto the suture. The tipping agent absorbed into the tipped portion can then be cured and cut to provide a tipped suture. The tipping process and apparatus can be used in conjunction with a needle-suture assembly process. The process advantageously controls application of a droplet of tipping agent to minimize the amount of tipping agent used, thereby providing an aesthetic needle-suture attachment. Apparatus are disclosed for performing the process.

This is a divisional of U.S. application Ser. No. 08/460,962, filed Jun.5, 1995 now U.S. Pat. No. 5,643,628.

BACKGROUND

1. Technical Field

The present apparatus and method relate to the tipping of surgicalsutures with tipping agent to stiffen a portion of the suture prior tocutting.

2. Background of the Art

Tipping of surgical sutures is known in the art and is generallyperformed to prevent the brooming of a multifilament surgical suturewhen cut so that it may be more easily inserted into the shank end of asurgical needle.

For many years, surgeons have employed needle suture combinations inwhich a suture or ligature is attached to the shank end of a needle.Such needle suture combinations are provided for a wide variety ofmonofilament and braided suture materials, both absorbable andnon-absorbable, e.g., catgut, silk, nylon, polyester, polypropylene,linen, cotton, and absorbable synthetic materials such as polymers andcopolymers of glycolic and lactic acid.

One typical method for securing a suture to a needle involves providinga cylindrical recess in the shank end of a needle and securing a suturetherein. For example, U.S. Pat. No. 1,558,037 teaches the addition of acement material to such a substantially cylindrical recess to secure thesuture therein. Additional methods for bonding a suture within a needlebore are described in U.S. Pat. Nos. 2,928,395 (adhesives) and 3,394,704(bonding agents). Alternatively, a suture may be secured within an axialbore in a needle by swaging the needle in the region of the recess. See,e.g., U.S. Pat. No. 1,250,114.

Insertion of sutures into a hole, recess or tube for attachment tosurgical needles presents problems peculiar to suture needlecombinations. Braided multifilament sutures in particular are difficultto insert into the very small aperture of a surgical needle; unlessmodified, they are too limp for the suture tip to be controlled forinsertion and they have a tendency to "broom", i.e, the filaments have atendency to flare out at the cut end so that the diameter of the cut endexceeds the diameter of the needle hole. Various techniques have beenemployed to modify sutures to overcome the problems of limpness andbrooming. One known method employs a tipping agent, which is a materialused to coat the suture to stiffen the filaments and adhere themtogether.

Typically, a suture to be tipped is first placed under tension to reduceslack so that the suture may be maintained in a predetermined positionon a frame or rack or other suture holding device. Optionally, thetension may be such as to reduce the diameter of the suture. SeeCanadian Patent No. 1,009,532. The suture is then dipped into thetipping solution and allowed to dry while under tension. The sutures arethen dried, such as by being warmed in a drying oven at about 225° F.for about 10 minutes. After drying the sutures can be cut and releasedfrom tension. The process results in a tipped end on each side of a cut.Where tension has optionally been employed to reduce the suturediameter, release of said tension will allow the suture to expand to itsoriginal diameter except at the tipped end portion. This can facilitateinsertion of the end into a needle.

Tipping agents may be dissolved in solvents to form dipping solutions.By way of example, Mariotte mixture is a dipping solution comprisingnylon dissolved in isopropyl alcohol. Other polymers and solvents mayalso be used. Gould mixture is a dipping solution comprising nylondissolved in methanol. At least one major manufacturer of surgicalneedles recommends use of Mariotte mixture or Gould mixture for tippingsutures. A multitude of other tipping agents, including polymers andsolvents, have been proposed. For example McGregor U.S. Pat. No.3,890,975 discloses coating the suture with a binding resin or adhesive.The composition may be any non-toxic adhesive composition, eitherorganic, inorganic or a hybrid. Suitable organic materials are suchnatural products as starch, dextrin, asphalt, animal and vegetableproteins, natural rubber, shellac, semi-synthetic products such ascellulose nitrate and the other cellulosies, polyamides derived fromdimer acids, castor-oil based polyurethanes; such well-known syntheticresins as vinyl-type addition polymers, both resins and elastomers;polyvinyl acetate, polyvinyl alcohol, acrylics, unsaturated polyesters,butadiene/acrylonitrile, butadiene/styrene, neoprene, butyl rubber,polyisobutylene; and polymers formed by condensation and other step-wisemechanisms, i.e., epoxies, polyurethanes, polysulfide rubbers, and thereaction products of formaldehyde with phenol, resorcinol, urea, andmelamine. McGregor states that particularly preferred bondingcompositions are epoxide resins and polyester resins.

Schmitt U.S. Pat. No. 3,736,646 discloses that it is known to tipbraided sutures by dipping the end of the suture in a plastic such as asolution in isopropyl alcohol. Schmitt suggest that for absorbablesutures an absorbable tipping agent is desirable, and proposes that acopolymer of lactic and glycolic acid dissolved in a suitable organicsolvent, such as xylene or toluene, be applied to tip the suture.

Nichols U.S. Pat. No. 2,734,506 discloses a dipping solution of polymersof methacrylic acid esters in an organic solvent such as toluene, xyleneacetone, ethyl acetate, methylethyl ketone, or naphtha.

Shepherd et al. U.S. Pat. No. 3,849,185 discloses the use of an acryliccasing syrup as a tipping agent, the syrup being fully polymerized afterbeing applied to the suture.

In addition, paraffin/hexane solution (10% paraffin has been used as asuture coating agent as well as Arrochem (TM), a nylon resin plusmethanol composition manufactured by ArroChem, Inc. of 201 Westland FarmRoad, Mt. Holly, N.C. 28120, and SILASTIC (TM) Medical Adhesive (asilicon elastomer composition manufactured by Dow Corning Co.)

An improved method of tipping sutures is disclosed and described in U.S.Pat. No. 5,269,808, which is herein incorporated by reference in itsentirety. In this method cyanoacrylate monomer is used as the tippingagent. The suture portion to be tipped is passed through a mist ofcyanoacrylate which has been generated by an ultrasonically powerednozzle. The cyanoacrylate hardens very rapidly after being absorbed intothe braided suture and adheres the filaments so that the filaments willnot broom when the tipped portion is cut. One of the advantages of thismethod is that the cyanoacrylate works very well on sutures which havepreviously been coated and/or filled with lubricants, and/or therapeuticagents and the like.

While the spray application of cyanoacrylate has been effective fortipping sutures there is yet a need to apply the cyanoacrylate or othertipping agent more efficiently. In particular, it would be desirable tominimize the length of suture tipped so that little, if any, of thetipped portion extends out of the needle shank after needle-sutureattachment.

SUMMARY

A method and apparatus for tipping a suture are provided herein. Themethod includes the steps of drawing a multifilament surgical sutureunder tension from a suture supply, dispensing one or more drops ofliquid tipping agent of predetermined size, contacting a portion of thesuture with the drop(s), and permitting the tipping agent to be absorbedinto the suture to create a tipped portion of the suture.

An optional elongated member oriented transverse to the linearorientation of the suture may be provided in order to lift the sutureinto contact with the drop. The elongated member is preferably anabsorbent string which can also be used to wipe excess tipping agentfrom the tipped portion of the suture.

The tipping agent is cured by a means suitable to the type of tippingagent being used and the suture is then cut to create a tipped end,which is then inserted into the barrel end of a needle.

Also contemplated is the use of non-absorbent strings to catch a dropletof tipping agent from the dispenser and carry the drop to the suture,which then absorbs the drop.

Alternatively, a suture twisting feature may be included to rotate thesuture to insure even exposure of the suture portion and coverage bytipping agent.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments are described with reference to the drawingswherein:

FIG. 1 is a perspective view of the apparatus.

FIG. 2 is a perspective view of the metered micropipette.

FIGS. 3 and 4 are end elevational views showing the application oftipping agent to the suture.

FIGS. 5, 6, and 7 are front elevational views of the stages of tipping,cutting, and needle suture assembly.

FIG. 8 is a perspective view of a wire guide system for suturealignment.

FIG. 9 is a perspective view of a collar for maintaining a controlledatmosphere.

FIG. 10 is a perspective view illustrating a transport string system forapplying a drop of tipping agent to a suture.

FIG. 11 is a perspective view of a suture tipping device includingstructure to twist the suture as tipping agent is applied to the suture.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT(S)

The following applications are incorporated by reference in theirentirety: U.S. application Ser. No. 08/309,705 filed Sep. 21, 1994directed to a method and apparatus for tipping, cutting, and sortingsutures; and U.S. application Ser. No. 08/297,202 filed Aug. 29, 1994,directed to a method and apparatus for micro-needle suture attachment.

As used herein, the term "braid" means a strand formed by crossing anumber (at least three) of individual yarns composed of one or morefilaments diagonally in such manners that each strand passesalternatively over and under one or more of the others. The terms "top","bottom", "above", "below", "over", "under", "distal", "proximal","forward", "rearward" and their variants, are used relative to eachother and do not refer to any external fixed frame of reference.

Overview of Process

The process described herein achieves tipping of surgical sutures in anefficient manner while providing a superior product. Less tipping agentis required and the length of suture which is tipped can be regulatedsuch that only that portion of the suture inserted into the needle isstiffened. The remainder of the suture, which is exposed to the bodytissue, advantageously remains limp.

1. The Suture Supply

The suture to be tipped is drawn off a supply spool under tension, theamount of tension preferably being sufficient to reduce the suturediameter by tightening the filaments.

Tipping processes are applied to multifilament surgical sutures,especially braided multifilament sutures. The braid may be oftraditional tubular braid construction or spiroid braid construction andmay include a core section composed of one or more filaments aroundwhich the braid is externally fabricated. Suitable braid constructionsare disclosed, for example, in U.S. Pat. Nos. 5,261,886; 5,059,213;5,019,093; 3,565,077; and 3,187,752.

The suture can be fabricated from a wide variety of natural andsynthetic fibrous materials. Such materials include non-absorbable aswell as partially and fully bio-absorbable (i.e., resorbable) naturaland synthetic fiber-forming polymers. Non-absorbable materials which aresuitable for fabricating sutures include silk, polyamides, polyesterssuch as polyethylene and polypropylene, silk, cotton, linen, etc.Bio-absorbable sutures may be fabricated from natural collagenousmaterial or synthetic resins including those derived from glycolic acid,glycolide, lactic acid, lactide, dioxanone, polycaprolactone,epsilon-caprolactone, trimethylene carbonate, etc., and variouscombinations of these and related monomers. Sutures prepared from resinsof this type are known in the art. See, e.g., U.S. Pat. Nos. 3,297,033;3,839,297; and 4,429,080.

Braided multifilament sutures typically are coated with one or morecoating compositions to improve functional properties such as surfacelubricity and knot tie-down behavior. A variety of suture coatingcompositions proposed for either or both of these purposes are wellknown in the art, e.g., those disclosed in U.S. Pat. Nos. 3,867,190;3,942,532; 4,047,533; 4,452,973; 4,624,256; 4,649,920; 4,716,203;4,826,945, 4,994,074; 5,123,912, and 5,312,437.

Absorbable braided sutures may also contain a storage stabilizing amountof a filler material containing at least one water soluble liquidpolyhydroxy compound and/or ester thereof. Such filling compositions aredisclosed in U.S. Pat. Nos. 5,051,272 and 5,037,429. Moreover, since thepolyhydroxy compounds are generally capable of dissolving a variety ofmedico-surgically useful substances, such as therapeutic agents, thesecompounds can be used as vehicles to deliver such substances to a woundor surgical site at the time the suture is introduced into the body.

As stated, a braided suture may be impregnated with one or moremedico-surgically useful substances, e.g., those which accelerate orbeneficially modify the healing process when the suture is applied to awound or surgical site. So, for example, the braided suture herein canbe provided with a therapeutic agent which will be deposited at thesutured site. For example, a therapeutic agent can be chosen for itsantimicrobial properties, capability for promoting wound repair and/ortissue growth or for specific indications such as thrombosis.Antimicrobial agents such as broad spectrum antibiotics (gentamicinsulphate, erythromycin or derivatized glycopeptides) which are slowlyreleased into the tissue can be applied in this manner to aid incombating clinical and sub-clinical infections in a surgical or traumawound site. To promote wound repair and/or tissue growth, one or morebiologically active materials known to achieve either or both of theseobjectives can be applied to a braided suture. Such materials includeany of several Human Growth Factors (HGFs), magainin, tissue or kidneyplasminogen activator to cause thrombosis, superoxide dismutase toscavenge tissue damaging free radicals, tumor neurosis factor for cancertherapy, stimulating factor, interferon, interleukin-2 or otherlymphokine to enhance the immune system, and so forth.

2. Suture Tipping

In the process described herein one or more droplets of tipping agentmay be applied to the suture either directly from a meteredmicropipette, or indirectly transferred from the micropipette to thesuture by a carrier. The apparatus described hereinbelow can dispensemicro droplets of such size as to effectively tip only that portion ofthe suture which is to be inserted in the shank end of a needle,typically about 0.1 inches. Preferably the droplets range in size fromabout 0.1 to about 0.3 microliters in volume. The tipping process isdescribed herein with reference to applying a single droplet of tippingagent to a suture. It is contemplated, however, that multiple dropletscould be applied.

Various tipping agents particular, the his process. In particular, theprocess described herein is especially advantageously used with acyanoacrylate tipping agent such as described in U.S. Pat. No.5,267,808. The cyanoacrylate is applied as a droplet of monomerwhereupon it is absorbed by capillary forces into the braid structure ofthe suture and later hardened by curing. The preferred cyanoacrylate isavailable under the name LOCTITE™ Medical Device Adhesive from theLoctite Corporation of Newington, Conn., and comprises 99+% ethylcyanoacrylate and small amounts of hydroquinone and organic anhydride.

Other tipping agents may be used instead of cyanoacrylate. One categoryof tipping agents includes solutions of tipping agents in solvents, forexample, Marriotte mixture or Gould mixture. Marriotte mixture is adipping solution composed of nylon dissolved in isopropyl alcohol. Whenthe solvent evaporates, a solid plastic remains to adhere the filaments.Gould mixture is a solution of nylon in methanol. Other tippingsolutions may be used, such as copolymers of lactic and glycolic aciddissolved in xylene or toluene, described in U.S. Pat. No. 3,736,646.U.S. Pat. No. 2,734,506 discloses a tipping solution of methacrylic acidester polymers in an organic solvent such as toluene, xylene, acetone,ethyl acetate, methylethyl ketone, or naphtha. U.S. Pat. No. 3,849,185discloses the use of an acrylic casting syrup as a tipping agent. Inaddition, paraffin/hexane solution has been used.

Other categories of substances useful in the present process areadhesives such as epoxy adhesives, adhesives cured by ultraviolet (U.V.)radiation, or adhesives which can be cured with, for example, curingaccelerators.

Water or another suitable liquid may be used as a tipping agent,provided that it is frozen for a duration of time sufficient to allowthe frozen portion of the suture to be cut and inserted into the needle.

Yet another category of materials which may be useful as a tipping agentare low melting point substances such as paraffin, resin, waxes, and thelike which are applied as a heated liquid and later stiffened by coolingbelow the melting point.

Tipping agents should be bio-compatible, and may also be bioabsorbable.Cyanoacrylate is the preferred tipping agent for use in the processdescribed herein because it is effective when used on sutures previouslycoated with lubricants and, under certain ambient conditions, it hardensalmost instantly. The last mentioned feature, quick hardening, has oftenmade cyanoacrylate difficult to work with. Surprisingly, a supply ofcyanoacrylate monomer sufficient for several hundred applications may bestored in a conventional metered micropipette without prematurehardening under most common ambient conditions. Under conditions of highhumidity, which catalyzes the polymerization of cyanoacrylate and whichmay cause premature curing, the micropipette may be surrounded with aprotective atmosphere of inert gas.

3. Tipped Suture Curing

After the suture is tipped, it may be passed through a curing station toharden the tipping agent. The specific procedure used in the curingstage will depend upon the type of tipping agent used. For example, whencyanoacrylate is used as the tipping agent the curing process involvestreatment with warm moist air. Table I below outlines various suitabletypes of curing processes applicable for the tipping agents mentionedabove.

                  TABLE I    ______________________________________    Tipping Agent    Curing Agent    ______________________________________    Cyanoacrylate    Warm moist air (70° C., 90-100%                     humidity)    Marriotte, Gould mixtures                     Warm, dry air (80-100° C.)    U.V. curable adhesives                     U.V. light    Paraffin, resins, waxes, water                     Cold air (0-20° C.)                     Liquid Nitrogen    ______________________________________

4. Suture Cutting

The suture is cut at the tipped portion to create one or two tipped endsfor insertion into a surgical needle.

Cutting may be accomplished by any of the methods currently employed tosever the suture. Typically a razor edge is passed laterally across thesuture.

5. Post-cutting processes

After cutting the suture optionally may be sorted according to size anddiameter. A method and apparatus for sorting sutures in conjunction witha tipping and cutting process and one usable within the tipping/curingmethod and apparatus described herein is disclosed and described in U.Sapplication Ser. No. 08/309,705.

6. Needle-Suture Assembly

The tipped end of the suture is finally inserted into the hole in theshank end of the needle. Needle-suture attachment processes andapparatus are well-known in the art. A process and apparatus for needlesuture attachment which can be used for both conventional sutures andmicrosurgical sutures and which may be used in conjunction with thetipping and curing process described herein is disclosed in U.S.application Ser. No. 08/297,202.

Other methods for attaching sutures to needles are described in U.S.Pat. Nos. 5,046,350; 4,922,904; 4,799,311; 4,722,384; 4,072,041;4,060,885; 4,054,144; and 3,910,282, for example.

THE APPARATUS

Referring now to FIG. 1 the apparatus 100 for micro-tipping sutures isshown.

Base 105 supports the apparatus. Suture 101 is initially wound on suturesupply spool 102 which is spring or clutch biased to maintain the sutureunder tension when the suture is drawn off. The suture 101 passesthrough aperture 104 in guide block 103 (see FIGS. 3-4), which maintainsthe suture in alignment. Suture 101 then passes through a tippingstation which includes a positioning mechanism 110 and tipping agentdispenser 120 which is mounted to a support frame (not shown).

The tipping agent dispenser 120, shown in more detail in FIG. 2, is ametered micropipette which comprises an elongated cannula 121 forholding a fluid tipping agent. Such micropipettes are commerciallyavailable and known to those with skill in the art. A control panel 122having push buttons 122a for programming and display panel 122b providesmeans for digitally programming the size of droplet 125 to be dispensedfrom the tip 123.

Referring to FIGS. 1, 3, and 4, a suture positioning system 110 includesa wiping string 111 which is oriented substantially transversely to thesuture 101 and which is transferred from one spool 112 to another spool113. The wiping string 111 is positioned underneath the suture 101.Lifting platforms 116 and 117 are positioned underneath the wipingstring 111 and are slidably movable along vertical tracks 118, 119,respectively, to upwardly bias the wiping string 111 which, in turn,lifts the suture 101 into contact with the droplet 125. The liftingplatforms 116 and 117 may be moved manually or automatically.

When the suture 101 is lifted into contact with the droplet 125, theliquid tipping agent is absorbed into the filaments of the suture 101.The wiping string 111, which is in contact with the suture 101, is thenmoved linearly from one to the other of spools 112 and 113. Wipingstring 111 is also preferably a multifilament string which wicks awayany excess tipping agent from the suture 101, although it iscontemplated that wiping string 111 may be a monofilament or othermaterial. The excess tipping agent is wiped away by the linear movementof the wiping string 111. The tipping agent spreads out and wets a shortportion of the suture, the amount of suture wetted being dependent uponthe size of the droplet 125, and the wiping action of string 111.Tipping agent penetrates the suture by capillary action.

After the tipping agent has been applied, lifting platforms 116, 117 arelowered to remove wiping string 111 from contact with suture 101. Thesuture is then advanced until the tipped portion passes through opening131 in shield plate 130 (see FIG. 1).

Next, the tipped suture portion passes through a curing station 140.Curing station 140 may be nothing more than exposure to ambient air, ifthat is sufficient to cure the tipping agent. Alternatively, the curingstation may provide other suitable conditions for curing the tippingagent. In one embodiment, curing station 140 includes a blower 141 wherecyanoacrylate tipping agent is used. Blower 141 may be connected to asource of warm moist air. The source of warm, moist air can comprise acolumn containing heated water through which air is bubbled. Thetemperature and humidity of the air may be chosen so as to achieve anoptimum cure rate for the cyanoacrylate adhesive. Typically atemperature of 70° C. and a relative humidity of 70%-100% aresufficient. When the portion of the suture to which a tipping agent hasbeen applied passes through the stream of warm, moist air, movement ofthe suture 101 may temporarily be halted to permit more contact timewith the warm moist air. Curing station 140 alternatively can provideheat, radiation, etc., depending upon the curing characteristics of theparticular tipping agent used.

A suture clamp 161 preferably is affixed to mounting frame 162, which isslidably mounted to longitudinally extending rails 107. Rails 107 aremounted along backframe 106. Movement of the suture 101 through theapparatus is effected by suture clamp 161, which grasps the suture inproximity to the previously tipped and cut end of the suture such thatat least the amount of suture inserted into the barrel end of the needledistally extends beyond the edge of the clamp 161. The suture is pulledunder tension. Preferably, a second clamp may be employed, the twoclamps alternately pulling the suture 101 then moving back to secure andpull the next section of suture. An example of such an arrangement isdescribed in U.S. application Ser. No. 08/309,705. A needle 171 ismounted to a needle support 172 at needle suture assembly station 170.The tipped end portion of suture 101 which extends distally from clamp161 is inserted into the opening in the barrel end of needle 171, andthe needle is then crimped by an appropriate crimping device (notshown). One suitable device is described in U.S. Pat. No. 5,350,373.

The suture 101 also passes through a cutting station 150 which mayinclude a frame 151 having a knife blade 152 slidably mounted therein.The suture 101 is positioned such that the suture is cut at the portionhaving the cured tipping agent to create the tipped suture end. As willbe appreciated, the clamp(s) 161 grasp the tipped suture adjacentcutting station 150 during cutting of the tipped suture portion tosupport the suture for cutting and to position the tipped suture endadjacent the clamp for insertion into the needle barrel end.

Referring now to FIG. 8 a preferred option is to additionally employwire guides for orienting the suture in the proper position for tipping.For example, in addition to the components of the tipping stationdescribed above, it is advantageous to include inverted V-shaped guides114 and 115 distal and proximal to the tip 123 of the tipping agentdispenser. When the suture 101 is moved upward by lifting string 111,suture 101 enters apex regions 114a and 115a which orient the suture inlateral alignment with tip 123 for precise deposition of droplet 125onto the suture 101.

Referring now to FIG. 9 an alternative embodiment of the apparatus isshown wherein the tipping agent dispenser 120 is surrounded by a collar180 having an inlet 182 and outlet slots 181. Elongated cannula 121 isdisposed through collar 180, the joint between them being sufficientlysealed to prevent outlet of considerable gas therebetween. Suture 101and lifting string 111 are disposed crosswise through slots 181 suchthat their crossing point is oriented with the tip 123 of the cannula 12(see FIG. 2). A substance inert to the tipping agent is pumped throughinlet 182 and surrounds the tipping area to prevent premature curing orhardening of tipping agent. Where cyancacrylate is the tipping agent, asuitable inert gas is dry nitrogen (N₂). Collar 180 is especiallyadvantageous when cyanoacrylate tipping agent is used a in anenvironment with high ambient humidity. The nitrogen within the collaris maintained at a slightly higher pressure than the atmosphere toassure that the outflow of nitrogen from slots 181 prevents the entry ofhumid air therethrough.

Referring to FIG. 10, another embodiment of the invention is shownwherein multifilament suture 101 is longitudinally passed underneath apair of transverse strings 111a and 111b. Transverse strings 111a and111b are substantially parallel to each other and spaced apart fromabout 0.01 to about 0.10 inches from each other. Strings 111a, 111b areoriented by a guide such as a bifurcated tubular guide 109 so that theypass underneath the tip 123 of the tipping agent dispenser 120. Strings111a, b receive a droplet 125 of tipping agent and suspend the dropbetween them. The transverse strings 111a and 111b are preferablymonofilament strings of about 0.006 inches in diameter which do notabsorb the tipping agent. Transverse strings 111a and 111b are spacedand configured to hold a droplet of tipping agent liquid on and betweenthem and transport the drop to suture 101. As indicated by directionarrows in FIG. 10, the transverse carrier strings 111a and 111b and theguide tube 109 are vertically movable. As a metered microdroplet oftipping agent 125 is deposited at tip 123 of the dispenser 120, carrierstrings 111a and 111b are moved upward to catch the droplet 125 which isthen held between them. The droplet size and surface tension andviscosity prevent it from falling through between the transverse carrierstrings 111a and 111b. Next, the strings 111a and 111b are lowered tocontact the droplet 125 with suture 101. Because the suture 101 is amultifilament suture having many interstices between its fibers andstrands, it possesses a capillary force which draws the droplet 125 offthe carrier strings 111a and 111b so that the droplet is absorbed intothe suture filaments. Carrier strings 111a and 111b can also be movedalong their own longitudinal axes so as to adjust the position ofdroplet 125 laterally with respect to suture 101. Thus, exact alignmentof suture 101 with tip 123 of the dispenser, although preferred, is notcritical. Indeed, the dispenser can be located somewhat remote fromsuture 101, with the carrier strings transporting the droplet of tippingagent to suture 101.

Referring to FIG. 11, in yet another embodiment the present apparatusmay include a suture twister to insure that the tipping agent wets theentire circumference of the suture portion to be tipped. As shown inFIG. 11, the suture twister 195 includes a frame 196, a disk 197rotatably mounted on the frame 196, a suture gripping clamp 198 mountedto the disk 197, and a disk turning gear 199 ratatably mounted on theframe 196. A second suture gripping clamp 198 (not shown) is mounted toguide block 103. Both the disk 197 and gear 199 have peripheral teethwhich are engaged such that rotation of gear 199 causes rotation of disk197.

To effect twisting of suture 101, suture gripping clamps 198 aretightened and gear 199 is rotated either manually or by a motor toeffect turning of the disk 197. This causes the suture 101 to twist. Thedisk 197 will have to be turned more than one complete rotation toresult in a complete rotation of the suture at the portion which isbeing tipped. The suture 101 may be contacted with the droplet fromdispenser 120 while twisting is being performed. After the tipping agentis absorbed, disk 197 is rotated back into its original position tountwist the suture and clamps 198 are released to permit passage of thesuture to the other stations of the apparatus.

The cut, tipped suture is inserted into a channel or drilled hole of aneedle and the needle is swaged or crimped to attach the suture to theneedle.

While the above description contains many specifics, these specificsshould not be construed as limitations on the scope of the invention,but merely as exemplifications of preferredembodiments thereof. Thoseskilled in the art will envision many other possible variations that arewithin the scope and spirit of the invention as defined by the claimsappended hereto.

As used in the claims:

"suture transport means" refers to the slidable suture clamp 161 andequivalent structures;

"means for contacting the suture and the drop of tipping agent" refersalternatively to transverse string 111, or strings 111a and 111b, andtheir structural equivalents;

"means for biasing the absorbent string" refers to the pair of liftingplatforms 116 and 117 which are slidably mounted to vertical tracks 118and 119;

"curing means" refers to the device 140 which may alternatively signifya blower of warm, moist air, warm, dry air, cold air, an ultravioletlamp, a dispenser of accelerator, or a dispenser of liquid nitrogen, orany equivalent structure suitable for curing the tipping agent beingused;

"twisting means" refers to suture twister 185.

What is claimed:
 1. An apparatus for tipping a surgical suture, whichcomprises:a) a supply of suture material; b) a liquid tipping agentdispenser capable of dispensing single predetermined size drops oftipping agent; c) suture transport means for linearly moving a suturefrom the supply of suture material; d) means for contacting a discreteportion of the suture with the drop of tipping agent to apply thetipping agent to the suture portion to create a tipped portion of thesuture.
 2. The apparatus of claim 1 wherein the liquid tipping agentdispenser comprises a metered micropipette.
 3. The apparatus of claim 1wherein the drop is from about 0.1 to about 0.3 microliters in volume.4. The apparatus of claim 1 further including curing means for curingthe tipping agent of the tipped portion of the suture.
 5. The apparatusof claim 1 wherein the tipping agent dispenser dispenses cyanoacrylate.6. The apparatus of claim 4 wherein the curing means comprises a warmair blower.
 7. The apparatus of claim 4 wherein the curing meanscomprises an ultraviolet lamp.
 8. The apparatus of claim 4 wherein thecuring means comprises a blower of cold air.
 9. The apparatus of claim 4wherein the tipping agent is water and the curing means comprises adispenser of liquid nitrogen.
 10. The apparatus of claim 1 wherein themeans for contacting the suture and the drop of tipping agent comprisesat least one elongated member oriented substantially transverse to theorientation of the suture and disposed between the suture and the drop.11. The apparatus of claim 10 wherein the at least one elongated membercomprises two spaced apart substantially parallel strings.
 12. Theapparatus of claim 11 wherein the two strings are each monofilamentstrands of a non-absorbent synthetic polymer.
 13. The apparatus of claim11 wherein the two strands are movable in a vertical direction, and in-alinear direction along the axis of the strands, the vertical directionand the linear direction of the strands being mutually orthogonal toeach other and to the linear orientation of the suture.
 14. Theapparatus of claim 11 further including a guide tube which maintains thestrands in spaced, parallel alignment.
 15. The apparatus of claim 1further including a collar disposed around the liquid tipping agentdispenser for maintaining a controlled atmosphere during application ofthe drop to the suture portion.
 16. An apparatus for tipping a surgicalsuture, which comprises:a) a supply of suture material; b) a liquidtipping agent dispenser capable of vertically dispensing singlepredetermined size drops of tipping agent; c) suture transport means forlinearly moving a suture from the supply of suture material; d) meansfor contacting a portion of the suture with the drop of tipping agent toapply the tipping agent to the suture portion to create a tipped portionof the suture, wherein the means for contacting the suture and the dropof tipping agent comprises an elongated member oriented substantiallytransverse to the linear orientation of the surgical suture, the suturebeing positioned between the elongated member and the drop, theelongated member being movable in a direction toward and away from thedrop to move a portion of the suture into contact with the drop.
 17. Theapparatus of claim 16 wherein the elongated member is an absorbentstring and the apparatus further comprises means for biasing theabsorbent string toward the drop.
 18. An apparatus for tipping asurgical suture, which comprises:a) a supply of suture material; b) aliquid tipping agent dispenser capable of dispensing singlepredetermined size drops of tipping agent; c) suture transport means forlinearly moving a suture from the supply of suture material; d) at leastone elongated member for contacting a portion of the suture with thedrop of tipping agent to apply the tipping agent to the suture portionto create a tipped portion of the suture; and, e) at least one guidemember for laterally aligning the suture with the drop when the sutureis moved by the elongated member.
 19. The apparatus of claim 18 whereinthe at least one guide wire includes at least two inverted V-shapedguide wires.
 20. An apparatus for tipping a surgical suture, whichcomprises:a) a supply of suture material; b) a liquid tipping agentdispenser capable of dispensing single predetermined size drops oftipping agent; c) suture transport means for linearly moving a suturefrom the supply of suture material; d) means for contacting a portion ofthe suture with the drop of tipping agent to apply the tipping agent tothe suture portion to create a tipped portion of the suture; and, e)twisting means for axially twisting the suture.
 21. An apparatus fortipping a surgical suture, which comprises:a) a supply of suturematerial; b) a liquid tipping agent dispenser capable of verticallydispensing single predetermined size drops of tipping agent; c) suturetransport means for linearly moving a suture from the supply of suturematerial; and d) linear means for contacting a portion of the suturewith the drop of tipping agent to apply the tipping agent to the sutureportion to create a tipped portion of the suture wherein the linearmeans comprises at least one movable substantially horizontal elongatedmember oriented substantially transverse to the linear orientation ofthe suture.
 22. An apparatus for tipping a surgical suture, whichcomprises:a) a supply of suture material; b) a liquid agent dispensercapable of dispensing single predetermined size drops of tipping agent;c) suture transport means for axially moving a suture from the supply ofsuture material; and d) at least one movable elongated member orientedsubstantially transverse to the linear orientation of the suture forcontacting a portion of the suture with the drop of tipping agent toapply the tipping agent to the suture portion to create a tipped portionof the suture.
 23. An apparatus for tipping a surgical suture, whichcomprises:a) a supply of suture; b) a liquid tipping agent dispensercapable of sequentially dispensing single predetermined size drops oftipping agent one drop at a time; c) suture transport means for axiallymoving the suture from the supply of suture; and, d) means movable in avertical direction for contacting a portion of the suture with thesingle drop of tipping agent to create a tipped portion of the suture.